2026 ECNP Congress

PS03-3071

Gender disparities in family functioning scales: psychometric study of 270 sexually compulsive individuals using FACES III, BT, and GARF

Lucas Park — M. Scanavino · Einstein Hospital Israelita, Psiquiatria, São Paulo, Brazil

2026 ECNP Congress

Compulsive Sexual Behavior Disorder (CSBD), classified by ICD-11 as a persistent failure to control intense, repetitive sexual impulses [1], carries profound psychosocial consequences including unemployment, relationship breakdown, and social isolation. Psychological theories consistently implicate disrupted family dynamics — childhood trauma, attachment failures, emotional neglect, and sexual abuse — as key etiological factors in CSBD development. Despite this, no prior study had examined the psychometric properties of standardized family functioning instruments in a clinical CSBD population. This study investigated the internal consistency, convergent validity, and discriminant validity of three family functioning measures — the Family Adaptability and Cohesion Evaluation Scale (FACES III) [2], the Beavers-Timberlawn (BT) Assessment of Relational Functioning Scale [3], and the Global Assessment of Relational Functioning Scale (GARF) [4] — and explored gender differences in family functioning profiles. A total of 270 individuals meeting ICD-10 criteria for excessive sexual drive (F52.7) and Goodman’s criteria for sexual addiction were enrolled (251 male, 19 female; median age 36 years [IQR 30–43]; median education 15 years; 57% heterosexual). Participants completed FACES III, BT, GARF, and the Childhood Trauma Questionnaire (CTQ) [5]. Internal consistency was assessed via Cronbach’s alpha, convergent validity through Spearman correlations, and discriminant validity using Mann–Whitney tests comparing scale scores between participants with and without childhood trauma per CTQ subscales. Factor analysis yielded a two-factor BT solution explaining 52% of variance: Factor 1 (Communication; 33%) and Factor 2 (Relationship; 19%). BT demonstrated high internal consistency (Cronbach’s α = 0.88) and FACES III adequate consistency (α = 0.78). BT Factor 1 correlated moderately with BT Factor 2 (Sp = −0.59, p < 0.001) and FACES Cohesion (Sp = −0.64, p < 0.001), and strongly with GARF (Sp = −0.75, p < 0.001). BT Factor 2 showed moderate correlation with GARF (Sp = 0.55, p < 0.001), while FACES Cohesion correlated moderately with GARF (Sp = 0.51, p < 0.001). BT Factor 1, BT Factor 2, FACES Cohesion, and GARF demonstrated significant discriminant validity, differentiating individuals with and without histories of physical abuse, emotional abuse, sexual abuse, emotional neglect, and physical neglect (all p ≤ 0.05). BT Factor 1, BT Factor 2, and GARF additionally discriminated suicide risk (p ≤ 0.05). FACES Adaptability failed to achieve significant discriminant validity across any trauma domain. Gender comparisons revealed women reported significantly worse family functioning than men on FACES Cohesion (Md: 27 vs. 45, p = 0.004), FACES Adaptability (M: 20.33 vs. 23.28, p = 0.047), and BT Factor 1 (Md: 34 vs. 29.5, p = 0.012), despite no gender difference in sexual compulsivity severity (p = 0.935). These findings provide the first empirical validation of FACES Cohesion, BT, and GARF as psychometrically sound instruments for assessing family functioning in CSBD. The markedly worse family functioning observed among women warrants urgent further investigation. These results establish a rigorous assessment framework to advance family-based intervention research and improve therapeutic outcomes in this underserved population.

References

  1. World Health Organization, 2019. International statistical classification of diseases and related health problems, 11th ed. WHO, Geneva.
  2. Olson, D., 2011. FACES IV and the circumplex model: Validation study. J. Marital Fam. Ther. 37 (1), 64–80.
  3. Beavers, W.R., 1982. Healthy, midrange, and severely dysfunctional families, in: Walsh, F. (Ed.), Normal family processes. Guilford Press, New York, 45–66.
  4. Kaslow, F., 1996. History, rationale and philosophic overview of issues and assumptions, in: Kaslow, F. (Ed.), Handbook of relational diagnosis and dysfunctional family patterns. Wiley, New York, 3–18.
  5. Grassi-Oliveira, R., Cogo-Moreira, H., Salum, G.A., Brietzke, E., Viola, T.W., Manfro, G.G., Kristensen, C.H., Arteche, A.X., 2014. Childhood Trauma Questionnaire (CTQ) in Brazilian samples of different age groups: findings from confirmatory factor analysis. PLoS One 9 (1), e87118.